Complications, Resource Utilization, and Cost of ABO-Incompatible Living Donor Kidney Transplantation
Complications, Resource Utilization, and Cost of ABO-Incompatible Living Donor Kidney Transplantation
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ABO 不相容活体肾移植的并发症、资源利用和费用
DOI：
10.1097/01.tp.0000226152.13584.ae
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发表时间：
2006
期刊：
影响因子：
6.2
通讯作者：
J. Gloor
中科院分区：
文献类型：
--
作者：
J. Schwartz;M. Stegall;W. Kremers;J. Gloor
背景活体同种异体肾移植跨越血型屏障需要降低抗血型抗体并将其维持在安全水平。这些方案导致资源利用和移植成本增加，并可能导致并发症增加。方法.在这项回顾性研究中，我们比较了40例ABO血型不合与77例匹配的ABO血型相容活体肾移植术后第-14天至第90天的并发症、资源利用和费用。结果总体而言，ABO血型不合组的手术相关并发症和资源利用增加，主要是由于脱敏方案和抗体介导的排斥反应。在没有排斥反应的情况下，两组的平均并发症数量相似。ABO不相容的肾脏移植比ABO相容的移植贵约38，000美元，但与在等待血型相容的已故捐献者肾脏的同时维持患者透析相比，具有成本效益。两组的移植物和患者存活率相似。结论.我们的结论是，ABO血型不合的活体供肾移植是一个可行的选择，患者的唯一供体是血型不兼容，尽管额外的资源利用和治疗费用。
Background. The transplantation of living donor renal allografts across blood group barriers requires protocols to reduce and maintain anti-blood group antibody at safe levels. These protocols lead to an increase in resource utilization and cost of transplantation and may result in increased complications. Methods. In this retrospective study, we compared 40 ABO-incompatible to 77 matching ABO-compatible living donor renal allografts with respect to complications, resource utilization, and cost from day −14 to 90 days after transplantation. Results. Overall, surgery-related complications and resource utilization were increased in the ABO-incompatible group, primarily due to the desensitization protocol and antibody-mediated rejection. In the absence of rejection, the mean number of complications was similar for both groups. ABO-incompatible kidney transplantation was approximately $38,000 more expensive than ABO-compatible transplants, but was cost effective when compared to maintaining the patient on dialysis while waiting for a blood group compatible deceased donor kidney. Actuarial graft and patient survival was similar in the two groups. Conclusions. We conclude that ABO-incompatible living donor kidney transplantation is a viable option for patients whose only donor is blood group incompatible despite the additional resource utilization and cost of therapy.